Thursday, April 13, 2006

The Story of Yeshasvini

I was reading a piece about Dr. Devi Shetty and Narayana Hrudayalaya and the story of Yeshasvini ( a self funding micro health insurance scheme) caught my eyes. It is captured vividly on their pages, here. Here are a few excerpts:

How the program was conceptualised.

...In spite of having the best of doctors and facilities in place, the rural masses lacked the capacity to pay for speciality care. Which is when, we initiated the Yeshasvini Health Scheme, a healthcare scheme for the rural masses to access quality healthcare at a nominal amount of Rs.5 (11 cents) per month. The program went on to become a successful venture of the Co-operative Department, Government of Karnataka.

...In a startling discovery, through an informal survey, we learnt that occupancy of hospital beds in Karnataka on an average stood at a mere 35%. The utilization of operation theaters was even lower.

...Through the study we concluded that it was not the lack of infrastructure, but the lack of paying capacity of the working class and the poor, which was the root cause of the mammoth healthcare problem India faced.

...Hence, began one of the most ambitious, self-funding initiatives to bring quality healthcare within the reach of the masses - the Yeshasvini Health Scheme.

...The Yeshasvini Health Scheme provided over 17 lakh farmers and their families quality healthcare, and that included costs of critical operations of the stomach, gall bladder, bones, eyes, uterus, brain and heart at a nominal Rs.5 (11 cents) per month.

While thats a tempting sum to be insured for, even for a sum that low, it was not easy to get healthy people to sign up. Therefore they took the route of approaching grameen banks, SHGs who were already together for a purpose.

...The Yeshasvini Health Scheme was open to people who were together for a purpose. Be it as a co-operative society, a grameen bank or quite simply for a reason other than health. This criterion was of paramount importance for the success of the scheme, because opening the scheme to everybody would have resulted in only people with diseases becoming members. This in turn would make a self-funding scheme unviable.

...The Yeshasvini Health Scheme entirely depended on numbers to keep it afloat. Working around the axiom that it costs Rs. 10,000 for a life saving operation, the Yeshasvini Health Scheme was open to a large number of people because, among 17 lakh members only a few thousand members are usually the ones with diseases. The other members are generally healthy members who pay for the treatment of the rest of the diseased members. (Moreover, the Yeshasvini Health Scheme enrolled members already diagnosed with diseases.)

So, what is offered?

The Yeshasvini Health Scheme covered approximately 1,700 different types of operations which included operations of the stomach, gall bladder, uterus, eyes, heart and brain, entirely free of cost. The only exception being - the price of implants like heart valves, which are required in very few patients. The members get free outpatient consultation in all Yeshasvini recognized hospitals. In addition, they also get inpatient treatment and outpatient investigations at discounted rates in these hospitals.

In a short span of time, the Yeshasvini Health Scheme has breathed a new lease of life in bringing quality healthcare within the reach of rural Karnataka. With its dynamic structure that generates funds to run itself, the Yeshasvini Health Scheme forms a working model for more such initiatives across the country.

In the first 7 months of its launch, 5,000 farmers underwent various types of operations and 23,500 farmers had out-patient medical consultation, entirely free for just Rs.5/- per month. That is the amazing power of a self-funding health scheme in action.

The story of Yeshasvini is also a story of how business can really go and help where it is needed most. It is about innovation, catering to the bottom of the pyramid, micro credit all rolled into one. It is also a story of what could have been done long ago by our governments with just a little thought. I am not sure that there are more schemes of this nature available or if there is any equivalent scheme available elsewhere in the world. But this one is truly a model worth emulation.

(Cross posted on The Indian Economy Blog)

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